California Pregnancy-Associated Mortality Review (CA-PAMR)

MO-07-0132 CA-PAMR

The California Pregnancy-Associated Mortality Review (CA-PAMR) is a project of the California Department of Public Health (CDPH), Maternal, Child and Adolescent Health (MCAH) Program in collaboration with the California Maternal Quality Care Collaborative (CMQCC), the University of California, San Francisco (UCSF) Institute for Health and Aging (IHA), and the Public Health Institute (PHI). CDPH/MCAH and the CA-PAMR project are fortunate to have the voluntary service of the CA-PAMR Committee, a statewide, multidisciplinary Committee comprised of leading clinical experts in maternal and perinatal health and public health. The CA-PAMR Committee serves to determine the causes of maternal mortality and to make recommendations concerning quality improvement opportunities in maternity care and public health strategies to prevent maternal deaths in California. Funding for CA-PAMR is provided by the Federal Title V Maternal and Child Health (MCH) Block Grant Funds.

Goals

CA-PAMR seeks to determine the causes of maternal mortality in California and to identify public health and clinical interventions to reduce maternal mortality and associated racial/ethnic disparities.

The goal of CA-PAMR is to identify women who died within one year of having a live birth or fetal death and to determine whether the death was pregnancy-related and the cause of death.

CA-PAMR strengthens California’s surveillance of maternal mortality and findings will be translated into public health prevention activities and improvements to clinical care designed to improve maternal outcomes.

Maternal mortality is a considered a sentinel event and serves as a warming sign of increased maternal morbidity, both chronic, underlying maternal medical conditions, as well as acute pregnancy-related injury or illness.

Program Activities

CA-PAMR was established in 2006 and review of maternal deaths in 2002 formed the basis for the first year of case review (the most recent data available at that time).

CA-PAMR consists of four components:

Enhanced surveillance of pregnancy-associated deaths by MCAH through the linkage of birth certificates with maternal and fetal death certificates and hospital discharge data;

Collection and abstraction of medical records by the Public Health Institute for deaths that are likely or known to be pregnancy-related;

Case review by the multidisciplinaryCA-PAMR Committee (PDF) to determine whether deaths are pregnancy-related, causation, factors that contributed to the deaths and recommendations for improvements in maternity care;